Viewpoints: Despite enrollment success, health law has internal problems; burdens for both parties

The New York Times: Health Care Without End
[F]or the foreseeable future, the health care debate probably isn't going to get any less intense. Instead, what we've watched unfold since 2009 is what we should expect for years, decades, a generation: a grinding, exhausting argument over how to pay for health care in a society that's growing older, consuming more care, and (especially if current secularizing trends persist) becoming more and more invested in postponing death. In the near term, this debate will go on because Obamacare has stabilized itself without fully resolving any of its internal problems (Ross Douthat, 4/5).

Los Angeles Times: Is Obamacare Too Big To Fail?
The program still faces a series of difficult tests -- most important, keeping costs under control so insurance premiums don't soar in coming years. And the program is certain not to be universally popular with its participants. Just think: Millions of newcomers to health coverage are about to join the rest of us in those frustrating battles with insurers. But the enrollment numbers do mean that the main argument Republicans hurled against the law -- that it was doomed to collapse -- is looking weaker than ever (Doyle McManus, 4/6).

The Washington Post: Can Democrats Change The Politics Of Health Care?
The debate over the Affordable Care Act has entered a new stage, one that will challenge Republicans and Democrats alike. But the burden still falls more heavily on the Democrats to show that the law can become something other than a political weight on vulnerable incumbents this year. With 7 million people now signed up under the health-care law, and more likely to join during future enrollment periods, the act is rapidly becoming embedded in the nation's health-care system (Dan Balz, 4/5).

Forbes: Get Ready For The Real Obamacare Disasters As People Start To Use It
The problems that will create the next headlines will come in three main flavors: lack of access to doctors, failures of the system to verify coverage and pay claims, and the incredibly high deductibles and copays on many of the exchange insurance policies. ... When these people first use their new coverage and a health care provider explains they owe a deductible and co-pay there is going to be a sudden and steep learning curve. Many doctor offices request immediate payment of these monies and many newly insured patients are going to be unable to make such payments. If they could afford a $6,000 deductible and 40 percent co-pays, they would have already had insurance (Jeffrey Dorman, 4/5).

The New York Times: As Vermont Goes, So Goes The Nation?
Three years ago, Peter Shumlin, the governor of Vermont, signed a bill creating Green Mountain Care: a single-payer system in which, if all goes according to plan, the state will regulate doctors' fees and cover Vermonters' medical bills. Mr. Shumlin is a Democrat, and the bill's passage is a credit to his party. Yet a small upstart spent years building support for reform and nudging the Democrats left: the Vermont Progressive Party (Molly Worthen, 4/5).

The Richmond Times-Dispatch: Expanding Medicaid Is Crazy
Recently, Democrat Dick Saslaw said "opposing Medicaid expansion is crazy," and "the reason for opposition is hatred of a black president." Nothing says desperation like the abandonment of any coherent argument. Democrats think that voters are so ill-informed that this rhetoric will win, but I have more respect for our voters than that. With this in mind, several of the innumerable reasons Medicaid expansion would be disastrous for Virginia are listed here (Va. State Sen. Tom Garrett Jr., 4/4).

The Richmond Times-Dispatch: Include Health Care In Virginia's Budget
The Affordable Care Act (ACA), otherwise known as Obamacare, is tearing our country apart; 56 percent of the public is now opposed to the ill-conceived and ineptly implemented ACA. But, despite my personal opposition to the plan, it is the law of the land. As long as it remains the law of the land, I believe it is the responsibility of state lawmakers to find a common-sense solution that makes the law as manageable as possible for our citizens (Va. State Sen. Walter A. Stosch, 4/4).

On other health care issues --

The Wall Street Journal: In Praise Of Medical Scribes
We often think that a complex problem (such as health care in the U.S.) requires a complex solution (Obamacare). Yet some important issues that are not adequately addressed with the current health-care overhaul include decreased patient and physician satisfaction, reduced access to care, and the increasing cost of care. For instance, the electronic medical record-keeping .... While the increased use of scribes will not address many important issues in health care, it would provide an inexpensive, market-based, partial solution to a number of them (Dr. Alan J. Bank, 4/6).

The New York Times: The Mentally Ill, Behind Bars
Mayor Bill de Blasio and his new correction commissioner, Joseph Ponte, have inherited a city jail system in which nearly 40 percent of the 12,000 inmates have mental illnesses -- up from about a quarter just seven years ago. Yet despite the stark shift, the system has not been redesigned to serve the complex needs of inmates with mental illnesses (4/6).

The Washington Post: Disclosing Medicare Payment Data Could Be A Boon For The Nation
Mr. Obama's administration has shown that it is possible to reform government significantly without a new act of Congress and without crossing constitutional boundaries. We refer to the Department of Health and Human Services' announcement that from now on it will greatly expand public disclosure of doctor-specific data on Medicare payments. This will enable the public to know, in detail, what happens to the $70 billion-plus that the program spends on physician services each year. Previously, such data had been off-limits due to supposed doctor privacy concerns (4/5).

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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